November 6, 2019
Reserve Your Hotel Now for ASIPP 2020 Meeting in Dallas

The ASIPP 2020 Meeting April 2-4 will be in downtown Dallas at the Hyatt Regency. The room block is now open for reservations. You may book online or by phone. Discounted rates end after March 17.

DISCOUNTED ROOM RATES FOR NIGHTS OF MARCH 31 – APRIL 5
Reserve by Phone
1-877-803-7534
Group Discount Code: G-SIPP

Reserve Online
Click here to reserve your room.

If you have questions about the room block or the meeting, contact Karen Avery at kavery@asipp.org / 270-554-9412 x 4210
Final CMS Payment Rules
for Interventional Pain Physicians
In-Office, ASC, and HOPD Settings
 
CMS released all 3 payment rules on November 1, 2019. These rules have multiple dates including:
 
1.         Interventional -Specific News
The good news, bad news, and ugly news continue to play out in the final rule, along with some errors, which we thought would be corrected, but have not.
 
1.1       Physician Payment Schedule
The CY 2020 Medicare Physician Fee Schedule (PFS) conversion factor is $36.09 (0.14% increase from CY 2019 conversion factor, was $36.04).
 
Overall, the cuts proposed for intercostal nerve blocks, vagus nerve block, ilioinguinal, and iliohypogastric nerve block reductions continue.
 
Some of the highlights include an increase in payment rates for sacroiliac joint nerve blocks, genicular nerve radiofrequency neurotomy, and sacroiliac joint nerve radiofreqency neurotomy, when performed in an office setting.
 
Sacroiliac joint fusion when performed in any setting.
 
1.2       Hospital Outpatient Department
Hospital outpatient departments continue to reap benefits wherein they are being paid double the payment of ASCs.
 
Of note is that interspinous stabilization device or prosthesis continues to face a 22.7% decline, along with a 62.3% decline for disc decompression.

New injection codes and genicular nerve block codes are paid appropriately in a hospital setting.
 
1.3       Ambulatory Surgery Centers
ASCs are paid less than 50% of hospital departments for non-implantables.
 
Most importantly, CMS has miscalculated payments for genicular nerve blocks and genicular radiofrequency neurotomy, which is 20% of the hospital payments instead of 50% of HOPD rate.
 
Multiple changes performed in the past have been preserved.
  • Interspinous prosthesis continues to face a 21.6% cut compared to 2019.
  • 64421 (Injection(s), anesthetic agent(s) and/or steroid; intercostal nerves, each additional level - converted to add-on code - No payments in ASC & HOPD settings).
  • Disc decompression faces a significant cut of 59%.
  • Trigeminal nerve blocks, greater occipital nerve block, vagus nerve block, and suprascapular nerve block continue to face significant cuts. 
 
2.         Site-neutral Payments
CMS will finish phasing in a policy adapted in 2018 to make payments for clinic visits site neutral by reducing payments for hospital outpatient clinic visits provided at off campus provider-based departments. Medicare will pay doctors the same amount for a basic visit, whether it takes place in a hospital outpatient facility or a regular doctor's office.
 
3.         Evaluation and Management, Coding, and Payment
The final sets separate payment rates for all 5 levels of coding for evaluation and management visits. The changes will be implemented on January 1, 2021.
 
4.         Medical Record Documentation
The final rule allows physicians, physician assistants, and advanced practice registered nurses to review and verify information in a patient's medical record that is entered by other clinicians, rather than re-entering the information.
 
5.          Telehealth Services
CMS will add a set of codes that describe a bundled episode of care for treatment of opioid use disorders, to the list of telehealth services covered by Medicare.
 
6.         MIPS - 2020 performance period
  • 45 points is the performance threshold (increased 15 points from PY 2019)
  • The Quality performance category is weighted at 45% (no change from PY 2019)
  • The Cost performance category is weighted at 15% (no change from PY 2019)
  • The Promoting Interoperability performance category is weighted at 25% (no change from PY 2019) 
Here are the links Payment rates for major IPM codes :
 
Physician Fee Schedule:
 
ASC Fee Schedule:
 
HOPD Fee Schedule:
 
The following is important information on the newly released 2020 final payment rules. ASIPP and SIPMS will be sending comment letters to CMS. You may also send comment letters to them on these payment rules no later than 5 p.m. EST on December 2, 2019.

Pain Physician
September/October 2019 Issue Features
 
The September/October issue of Pain Physician features a cost utility analysis of cervical interlaminar epidural injections as well as several systematic reviews, randomized trials and original research.
 
Cost Utility Analysis
Laxmaiah Manchikanti, MD, Vidyasagar Pampati, MSc, Allan Parr, III, MS, Maanasa V. Manchikanti, Mahendra R. Sanapati, MD, Alan D. Kaye, MD, PhD, and Joshua A. Hirsch, MD.

Narrative Review
Inna Blyakhman, MSc, and Krishnan Chakravarthy, MD, PhD.

Comprehensive Review
Ajay B. Antony, MD, Anthony J. Mazzola, MD, Gurpreet S. Dhaliwal, MD, and Corey W. Hunter, MD.

Narrative Review
Gabriel Fregoso, MD, Annie Wang, MD, Kelly Tseng, MD, and Jingping Wang, MD, PhD.

Retrospective Review
Leonardo Kapural, MD, PhD, Nicholas Lee, ., Kevin Neal, MD, and Michael Burchell, MD.
 
JUNE 2020 ABIPP EXAMS
AND COMPETENCY EXAMS
June 27 - June 28, 2020 | Memphis, TN
 
The American Board of Interventional Pain Physicians ( ABIPP ) has developed certification programs that recognize accepted levels of knowledge and expertise in the interventional pain management
profession, with the goal of improved patient care. Hundreds of qualified physicians have made the commitment to become ABIPP certified.
ABIPP now offers the only competency certification program for regenerative medicine.
 
For complete information about the examination requirements and to obtain an application packet, visit www.abipp.org or call 270-554-9412 x4217 or by email at summer@asipp.org.
 
June 27
ABIPP Part I  
Combined CSM/CCPM Exam for ABIPP Path
Competency Exam in Controlled Substance Management
Competency Exam in Coding, Compliance, and
Practice Management
 
June 27-28
ABIPP Part II  
ABIPP Competency Exam
Regenerative Medicine Competency Exam
Endoscopic Lumbar Decompression Competency Exam
 
939 Ridge Lake Blvd. | Memphis, TN 38120  
Join the AMA to help us keep our seat in the House of Delegates
 
The American Medical Association (AMA) requires all societies to requalify for membership in the AMA House of Delegates (HOD) every five years. In order for ASIPP to retain our seat, the AMA requires that 20% of ASIPP’s physician members also be members of the AMA. Unfortunately, ASIPP is at risk of losing representation in the AMA because we have fallen below the 20% membership minimum threshold.
 
Membership in the AMA gives us a voice in shaping policy that affects our practice and patients.
We encourage you to join or renew your membership in the AMA. Joining the AMA will further strengthen our specialty’s representation at the national level through the AMA House of Delegates, the AMA’s policymaking body, and strengthen our ability to meet the challenges in health care today with thoughtful, well-organized responses.
 
We strongly encourage you to join the AMA today to help us keep our seat at the table. Right now, you can become a member and pay only half the dues.
 
The stronger our membership, the more we can advance issues that are important to our specialty including improving the Medicare Quality Payment Program, reducing administrative burdens and ensuring accurate coding and reimbursement of our services.
 
Thank you for supporting ASIPP!
 
Click HERE to join today and pay only half price! 


Docs to See Major Reforms in Medicare Pay
MIPS overhaul to come in 2021; new rule also relaxes physician supervision for PAs
 
WASHINGTON -- The Centers for Medicare and Medicaid Services (CMS) released a final rule on Friday that agency officials argue will streamline billing and coding and reward physicians for spending more time caring for patients.

Parts of the new regulation, which is focused on updating physician payment in the Medicare program, build on the executive order President Trump issued on Oct. 3.

Prevalence and Profile of High Impact Chronic Pain
 
Almost 11 million U.S. adults have “High Impact Chronic Pain.” That is, pain that has lasted 3 months or longer and is accompanied by at least one major activity restriction, such as being unable to work outside the home, go to school, or do household chores. These people report more severe pain, more mental health problems and cognitive impairments, more difficulty taking care of themselves, and higher health care use than those who have chronic pain without these activity restrictions, according to an analysis of national survey data by researchers from the National Center for Complementary and Integrative Health’s Division of Intramural Research and collaborating institutions, published in the Journal of Pain .

Chronic pain is a common problem, affecting about 40 million U.S. adults, but its impact on people’s daily lives has been difficult to define. The U.S. National Pain Strategy proposed adding disability (activity limitations) to the standard definition of chronic pain (which is based on how long the pain has lasted) to get better information on the impact of chronic pain on the U.S. population. This study analyzes 2011 National Health Interview Survey data on chronic pain accompanied by restrictions in major life activities (High Impact Chronic Pain) and chronic pain without these limitations.
 
NIH
Key takeaways from CDC's 2018 U.S. health report

New data from the 2018 U.S. Health report published by the Centers for Disease Control and Prevention's National Center for Health Statistics depict a grim outlook for the U.S., with exorbitant healthcare spending and increased rates of drug overdose deaths, vaping use, obesity and prescription drug use. However, a decline in teen birth rates, cigarette use and infant mortality rates provide silver linings.   

Drug overdose mortality
  •  The death rate for drug overdoses increased 82 percent from 2007 to 2017, a jump from 11.9 to 21.7 deaths per 100,000 people.
  • Drug overdose death rates were higher among males than females for all ages except those 65 and over.

5 ways opponents are going after Warren’s 'Medicare for All' plan

Elizabeth Warren’s highly detailed plan to raise the roughly $20 trillion needed to pay for "Medicare for All" opened her up to attack from all sides. While the plan won praise from progressives for going hard on the rich, drug companies and Wall Street, it generated questions about taxation, fairness and practicality that Warren is certain to face in the next Democratic debate.

Here are some of the ways Warren’s Democratic rivals, conservative critics and progressive wonks are going after her plan and whether those attacks are likely to hit home:

1. The numbers don’t add up
Warren’s Democratic primary rivals immediately pounced on her calculation of the cost of Medicare for All, noting that it clocks in much lower than the figure Sen. Bernie Sanders has been citing on the campaign trail — a difference Warren attributes to how her plan would aggressively bargain down the price of prescription drugs, eliminate a huge amount of waste in the system, and slash payments to doctors and hospitals, among other differences.
 
Interventional Pain Management Reports is an Open Access online journal, a peer-reviews journal dedicated to the publication of case reports, brief commentaries and reviews and letters to the editor. It is a peer-reviewed journal written by and directed to an audience of interventional pain physicians, clinicians and basic scientists with an interest in interventional pain management and pain medicine. 

Interventional Pain Management Reports is an official publication of the American Society of Interventional Pain Physicians (ASIPP) and is a sister publication of Pain Physician . Interventional Pain Management Reports Interventional Pain Management Reports is an open access journal, available online with free full manuscripts.  

The benefits of publishing in an open access journal that has a corresponding
print edition journal are:  
  • Your article will have the potential to obtain more citations.
  • Your article will be peer-reviewed and published faster than other journals.
  • Your article can be read by a potentially much larger audience compared with traditional subscription-only journals.  
  • Open Access journals are FREE to view, download and to print.

So submit today your:
  • Case Reports
  • Technical Reports
  • Editorials
  • Short Perspectives

CMS Grants Ambulatory Surgery Centers' Wish
 
Against strenuous objection from hospital trade groups, ambulatory surgery centers can start receiving reimbursement for fee-for-service Medicare beneficiaries undergoing total knee replacement and mosaicplasty procedures, coronary angioplasties, and placements of stents starting Jan. 1.

"We have determined these procedures would not be expected to pose a significant risk to beneficiary safety when performed in an ASC," the Centers for Medicare & Medicaid Services said in its final outpatient rule released Friday. The agency added its belief that "standard medical practice would not dictate that the beneficiary would typically be expected to require active medical monitoring and care at midnight following the procedure."
 
2019 MIPS Reporting? Start Now.
MIPS-eligible clinicians must report a full year of data. Don’t fall behind – keep up with NIPM-QCDR.
 
MIPS 2019 has brought larger payment adjustments and greater reporting requirements, including a 365-day performance period for the Quality and Cost categories. The sooner you start your MIPS reporting for 2019, the better.
Sign up today to use ASIPP’s NIPM-QCDR for MIPS.
This powerful tool makes MIPS reporting easy through the use of our new patient-reported outcomes measures for 2019, which ease the burden on providers and reduces costly EMR integration.

Get started today at ASIPP.ArborMetrix.net

Workplace Sugary Drink Sales Ban Tied to Health Improvements
-Employee health may benefit from a workplace soda ban and motivational intervention

Study Authors: Elissa S. Epel, Alison Hartman, et al.

Target Audience and Goal Statement: Cardiologists, endocrinologists, weight loss specialists, primary care physicians

The goals of this study were to evaluate if a workplace sugar-sweetened beverage (SSB) sales ban would affect SSB intake and cardiometabolic health among employees at a large college campus and if a brief motivational intervention provided added benefits to the sales ban.

Question Addressed:
  • Was a workplace sales ban on SSBs (defined as sodas, sports or energy drinks, "fruit" drinks, and sweetened bottled teas and coffees) associated with a reduction in employee intake of these drinks and improvement in their cardiometabolic health?
 
 
Opioid Crisis Fast Facts

(CNN) Here's a look at the  opioid crisis.

Experts say the United States is in the throes of an opioid epidemic.  An estimated 10.3 million Americans aged 12 and older misused opioids in 2018,  including 9.9 million prescription pain reliever abusers and 808,000 heroin users.

Opioids are drugs formulated to replicate the pain-educing properties of opium. Prescription painkillers like morphine, oxycodone and hydrocodone are opioids. Illegal drugs like heroin and illicitly made fentanyl are also opioids. The word "opioid" is derived from the word "opium."

During 2017, there were  more than 70,200 overdose deaths  in the United States and 47,600 of those   overdose deaths involved opioids.  More than 130 people died every day  from opioid-related drug overdoses in 2016 and 2017, according to the US Department of Health & Human Services.

CNN
State Society News 


Send in your state society meeting news to Holly Long, hlong@asipp.org
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